Week 1 - Stroke Flashcards
(21 cards)
What is a stroke?
Stroke is a clinical syndrome characterised by rapidly developing clinical symptoms and/or signs of focal neurological deficit lasting more than 24 hours and thought to be of vascular origin
Epidemiology facts of stroke in the UK
- > 100,000 strokes per year
*38000 of these die
*There are 1.2million stroke survivors
*2/3 of patients leave hospital with disability
*1/3 of strokes occur between age 40 and 69
*Life time stroke risk 1:6
*£8.6billion cost to NHS and social care/year
If you are right handed which side of the brain is the dominant side
The left
What are the 2 types of strokes?
ischaemic
Haemorrhaging
What symptoms do you get with TACS
motor or sensory loss
Cortical e.g. dysphasia, neglect etc.
Homonymous hemianopia
MUST have all 3 to qualify
What symptoms do you get with LACS
Pure motor (internal capsule, pons)
Pure sensory (thalamus)
Sensorimotor
Ataxic hemiparesis (pons)
Movement disorders
What symptoms do you get with POCS
Isolated hemianopia;
brain stem signs;
cerebellar ataxia
Hemiparesis
Hemisensory loss
Vertigo, vomiting
Diplopia
Facial weakness /numbness
Dysphagia
Respiratory failure
Coma & Death
What is a TIA?
Transient Ischaemic Attacks - neurological signs that are consistent with a stroke that last for less than 24hrs
What score do you use to determine the risk of stroke during 7 days after TIA is highly predictable
ABCD2 score
Which is more common - ischaemic or haemorrhaging stroke?
Ischaemic - 85%
Haemorrhagic - 15%
What treatment is there to reduce risk of stroke following TIA
Dual antiplatelets - aspirin and clopidogril
PPI
Do statins help
Yes reduce LDL - reduce Plaque and clot formation reduce risk of stroke
Low BP - lower risk of stroke
What procedure do you do if artery stenosis of more than 50% and symptomatic
Carotid endarterectomy
What does a haemorrhage look like in a CT head
Bright white
What does a haemorrhage look like on an MRI
dark
Lighter dark - recent
Darker dark - older
What does an old haemorrhage look like on CT
Dark
Early white
Old dark
What are the 2 drugs for thrombolysis
Alto please or tenectoplase
What is it called when the brain swells and pushes down
Conning
What do you do to manage ICH (haemorrhage)
stop anticoagulants
Reverse affects of all anticoagulants
Lower the BP to less than 150 systolic
What is tone?
how much resistance the patient has
Low tone - floppy - risk of shoulder dislocation etc - positioning is very important
How long after a stroke are they allowed to drive again
1 month
